At Grady Health System in Atlanta, monitoring key performance indicators (KPI) always comes back to the foundation KPI: hospital late charges. The timing of posting charges has a ripple effect. The longer you wait to post a charge, the more likely it is you will miss something.
Q: When an acute rehabilitation hospital transfers a patient at 11:45 p.m. to an acute hospital emergency department, which sends the patient back to acute rehab the next morning, who is responsible for the bill?
As revenue integrity departments continue to evolve, facilities are often faced with the challenge of determining which tasks must fall to these departments and which are best suited for other revenue cycle roles. With so many department functions overlapping, defining revenue integrity-specific functions is a complex task.
Transitioning to an electronic health system comes with its challenges, from learning new software systems to updating staff roles. Understanding the resources your facility has available is critical to adapting to these changes.
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a treasure trove of data that can help hospitals adapt to the world of value-based purchasing, reduce risk, and stay ahead of audits. But understanding how to...
Claims returned with NCCI edits or medically unlikely edits (MUE) can easily be lost in the shuffle. Often, it’s not clear who is responsible for resolving an edit, leading to further delays with accounts receivable. Properly...
Every piece of a cost report tells CMS your facility’s story, and it’s your responsibility to ensure the story is accurate. The data included on cost reports can impact a facility’s revenue for years to come—influencing payment on...
